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Lost IUD threads — DRCOG MCQ

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ModerateContraception and Sexual HealthLost IUD threadsDRCOG

A 35-year-old woman with a copper IUD inserted 2 years ago cannot feel the threads. She has no pain, bleeding or fever. Pregnancy test is negative and speculum examination cannot visualise the threads. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Pelvic ultrasound to confirm IUD position

Missing IUD threads with a negative pregnancy test should be assessed with imaging, usually ultrasound, to confirm intrauterine location. Blind removal risks trauma and may fail if the device is not in the cervix. Antibiotics are not indicated without infection. The pearl is that pregnancy must be excluded first whenever threads are missing.

Reference: FSRH Intrauterine Contraception guideline